Imipenem reduces the efficacy of vancomycin against Elizabethkingia species.

Autor:	Yang YS; Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan., Chen HY; Department of Medical Techniques, Taipei City Hospital Ren-Ai Branch, Taipei, Taiwan., Lin IC; National Defense Medical Center, Institute of Preventive Medicine, Taipei, Taiwan., Lin MH; National Defense Medical Center, Institute of Preventive Medicine, Taipei, Taiwan., Wang WY; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan., Kuo SC; National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan., Chen WT; National Defense Medical Center, Institute of Preventive Medicine, Taipei, Taiwan., Cheng YH; National Defense Medical Center, Institute of Preventive Medicine, Taipei, Taiwan.; Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, Taiwan., Sun JR; Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.; National Defense Medical Center, Institute of Preventive Medicine, Taipei, Taiwan.; Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2024 Aug 01; Vol. 79 (8), pp. 2048-2052.
DOI:	10.1093/jac/dkae210
Abstrakt:	Background: Elizabethkingia spp. are emerging as nosocomial pathogens causing various infections. These pathogens express resistance to a broad range of antibiotics, thus requiring antimicrobial combinations for coverage. However, possible antagonistic interactions between antibiotics have not been thoroughly explored. This study aimed to evaluate the effectiveness of antimicrobial combinations against Elizabethkingia infections, focusing on their impact on pathogenicity, including biofilm production and cell adhesion. Methods: Double-disc diffusion, time-kill, and chequerboard assays were used for evaluating the combination effects of antibiotics against Elizabethkingia spp. We further examined the antagonistic effects of antibiotic combinations on biofilm formation and adherence to A549 human respiratory epithelial cells. Further validation of the antibiotic interactions and their implications was performed using ex vivo hamster precision-cut lung sections (PCLSs) to mimic in vivo conditions. Results: Antagonistic effects were observed between cefoxitin, imipenem and amoxicillin/clavulanic acid in combination with vancomycin. The antagonism of imipenem toward vancomycin was specific to its effects on the genus Elizabethkingia. Imipenem further hampered the bactericidal effect of vancomycin and impaired its inhibition of biofilm formation and the adhesion of Elizabethkingia meningoseptica ATCC 13253 to human cells. In the ex vivo PCLS model, vancomycin exhibited dose-dependent bactericidal effects; however, the addition of imipenem also reduced the effect of vancomycin. Conclusions: Imipenem reduced the bactericidal efficacy of vancomycin against Elizabethkingia spp. and compromised its capacity to inhibit biofilm formation, thereby enhancing bacterial adhesion. Clinicians should be aware of the potential issues with the use of these antibiotic combinations when treating Elizabethkingia infections. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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